According to a story in today's Sun, Congressional leaders are still trying to figure out a way to pass health care reform -- albiet quietly.

Democrats may try and persuade House members to vote for the Senate package and then go back and fix some things later under a budget procedure that is filibuster proof. Or they may seek a scaled down package that can pass both chambers.

But after the loss of former Sen. Ted Kennedy's seat in Massachusetts to a Republican, possibly due in part to voter anger over the economy, Dems are trying to keep the negotiations low key. They'd like to appear to be working full-time on job creation.

Indeed, President Obama barely touched on the subject of health care reform in his State of the Union message. But you can read more about the President's plan and watch a video at whitehouse.gov.

Meanwhile, some medical groups, including the American College of Physicians, are urging lawmakers not to give up on reform this year.

So, what do you think? Did the Dems overreach? Or, should they keep pushing for coverage for the millions who don't have it and protections for those who do?

Associated Press file photo of the State of the Union speech

Posted by Meredith Cohn at 12:00 PM | Permalink | Comments (1)
Categories: Health care reform
        

Everyone's weighing in on the State of the Union address last night in which President Obama chose his words very carefully when discussing health care.

He called it "health insurance reform"-- not health care reform. And he was candid about the political drama that has unfolded since he championed overhauling the nation's health care system: "And by now it should be fairly obvious that I didn't take on health care because it was good politics," he said.

While the president didn't mention health care until 40 minutes into the speech, he made an impassioned plea to his party not to abandon the issue and practically begged lawmakers to try to see past their differences and get a bill passed, explains this AP story. He even pressed Republicans and other naysayers who don't like the bill, to come up with a plan of their own.

He admitted that he didn't do the best job selling reform to the public, but argued that without it, things will only get worse.

I take my share of the blame for not explaining it more clearly to the American people.  And I know that with all the lobbying and horse-trading, the process left most Americans wondering, "What's in it for me?"

But I also know this problem is not going away.  By the time I'm finished speaking tonight, more Americans will have lost their health insurance.  Millions will lose it this year.  Our deficit will grow.  Premiums will go up.  Patients will be denied the care they need.  Small business owners will continue to drop coverage altogether.  I will not walk away from these Americans, and neither should the people in this chamber

You can find the President's full remarks here.

Continue reading "Obama takes on "health insurance reform" in State of the Union" »

Posted by Kelly Brewington at 12:20 PM | Permalink | Comments (1)
Categories: Health care reform
        

Nurses can help reduce medical errors, promote wellness, increase efficiency and help hospitals cut costs. But rarely are they seen as important decision makers, not to mention, revenue generators as compared to doctors, according to a new survey from Gallup and the Robert Wood Johnson Foundation.

When it comes to health care reform, nurses have a lot to offer, the survey found. Problem is, they're unlikely to have much influence compared to doctors and insurance and pharmaceutical executives. Seventy-five percent of people polled said government officials will have huge impact on health reform in the next five to ten years. Just 14 percent said nurses would.

"Nurses are highly trusted sources of health care information, but as we look to reform our health system, our nation is not taking advantage of all that nurses have to offer," said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation in a statement. "This survey shows that opinion leaders recognize that we are squandering opportunities to learn from nurses and implement their ideas. We must build on the widespread trust of nurses’ expertise as an essential component in leading and implementing reform."

The foundation polled 1,500 people across health care industry, from insurance companies to university faculty for a look at nursing roles. We spoke a lot about that a few weeks ago in the post on depictions of nurses on TV. Well, this survey suggests some of those televised stereotypes are all too common in real life.

Nurses should work to make their voices heard, the report states. Likewise, nurses should be held accountable for taking a lead on health reform. What do you think?

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Health care reform
        

With Republican Scott Brown winning Ted Kennedy's Senate seat in Massachusetts last night, the Democrats have lost their filibuster-proof majority, throwing a huge stumbling block in their way to get a health bill to the president's desk. 

So what's the fate of health reform? Well, that's the billion dollar question everyone's trying to figure out today. Here are a few good explanations, so far:

The effort's not dead yet, say some analysts. But the options are few and very complex, says this update from the Politico.

In one backup plan, House Democrats may try to approve the Senate version of the bill. While the bills are similar, there are big differences that could be difficult to iron out, says this story in the WSJ. House lawmakers don't like the Senate version's tax on big insurance plans and smaller subsidies to help low income people buy insurance, to name a few. 

Others offer a gloomier picture. This Slate piece predicts reform doesn't have a hope, and maps out four scenarios for why this is the case.  

Posted by Kelly Brewington at 12:20 PM | Permalink | Comments (2)
Categories: Health care reform
        

The new year brings a new skirmish on the health care reform front. As leaders in the House and the Senate prepare to merge their very different versions of the health care bills, here are some great resources for following the debate:

+   The Kaiser Family Foundation -- not the insurance carrier -- provides a nifty web tool providing side-by-side comparisons of the bills. You can also choose a health care issue, like say, "individual mandate" or "financing" and make your own cheat sheet on how the bills stack up. It's comprehensive, easy to use and has become my favorite tool as I write and research health reform stories.

+   The news agency run by the Kaiser Family Foundation -- Kaiser Health News --provides a solid Q&A on some pressing issues, including: Q: I want health coverage, but can't afford it. How would the legislation affect me?

+   This Associated Press feature offers highlights of the plans and examples how they would impact real people from a 28-year-old single woman who works part time to a 60-year-old married man who is self-employed.

+   Young, healthy and still bristling at the notion of being forced to carry health insurance? Check out The Sun's website for this explanation of why Congress is mandating insurance coverage. Our site also has another helpful breakdown of the highlights of each bill. 

And with that, let the wrangling begin!

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

There are lots of assumptions made about the U.S. health care system and how it differs from say, the British nationalized model. In America, everyone has unfettered access to top-notch drugs, while the Brits ration their care, goes the stereotypes. That leads many critics of U.S. health reform efforts to assume the American system is just fine the way it is.

But a new study by Johns Hopkins researchers finds the perceptions aren't so. The study compares the two systems' access to the most expensive cancer medications and asks: Which is more fair? And which cancer patients are better off?

The study, appearing in Milbank Quarterly, compared the costs of 11 pricey cancer drugs. In the UK, seven are free to all patients, with no out-of-pocket costs. Four aren't because they aren't considered worth the limited benefit. If patients want those drugs, they need to pay up.

Here at home, people with insurance have some coverage of all 11 drugs--but the range of out of pocket costs are enormous, depending on the carrier.

Both systems involve a kind of rationing, concludes the study. And here's something that will make reform foes gasp: The issue isn't whether rationing is good or bad, argues the reports' author, Ruth R. Faden, director of the Johns Hopkins Berman Institute for Bioethics. That's because no system can provide patients every medication or intervention to every patient all the time, she writes.

"The issue is what we should do about extraordinarily expensive treatments, some of which do very little to improve how well or how long people live," said Faden in a statement. At the same time, she adds, "there is no ethically defensible reason why some Americans have access to expensive cancer drugs and some do not."

Continue reading "Who gets expensive cancer drugs? And thoughts on rationing" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Cancer, Health care reform
        

With the Senate in a pinch to meet a Christmas deadline to pass a health reform bill, a new report paints a bleak picture for Maryland if reform doesn't happen.  

Some 482,000 people in Maryland will gain coverage by 2019 under the Senate health reform bill, according to the report by the national consumer advocacy group Families USA. Without it, about 125,000 people in Maryland will lose coverage by that same date.

In 2007 and 2008, the average number of uninsured in Maryland was 715,000, but that figure could rise to 840,000 if the Senate goes home for Christmas without a bill, the report estimates. Nationally, the number of people without insurance could hit 54 million in 2019 without a health care overhaul.

The group, which if you haven't noticed, has been lobbying big time for the Senate to hurry up and pass legislation to expand coverage to millions. It has come out with similar sobering figures on the impact that the status quo could have on the states.

A few months ago, the group released a report estimating that 114,780 people will lose health coverage in Maryland from 2008 through December 2010.

photo courtesy of Brooks Elliot @ flickr

Posted by Kelly Brewington at 12:04 PM | Permalink | Comments (1)
Categories: Health care reform
        

New research puts a number on the cancer risk that the growing number of CT scans can pose patients -- the latest evidence that the scans may be overused.

The 70 million CT scans done in 2007 -- a jump from just 3 million in 1980 (!) -- could ultimately cause 29,000 new cancer cases, according to estimates from the study, which appears in the latest Archives of Internal Medicine. 

Doctors like the scans because they provide super-clear pictures inside the body. Their use has transformed medicine, allowing earlier diagnoses and treatment. But the research, the latest among several papers of late to raise doubts about whether CT scans make people healthier, suggests the imaging can do more harm than good. 

We've written before about not only the potential dangers of excessive imaging -- but how it contributes to skyrocketing health care costs. Those scans are pricey and can bring in big money to doctors practices, hospitals and imaging centers.

At a time when the nation is trying to rein in health care costs, could more prudent use of CT scans help?

Continue reading "CT scans, cancer risk and health care costs" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Cancer, Health care reform
        

Just last week, the American Medical Association loudly objected to lawmakers' proposal to expand Medicare because, it insists, the federal insurance doesn't pay enough as it is.

Not all doctors agree with the AMA. In fact, in this Op-Ed published yesterday in The Sun, a group of Hopkins doctors-in-training say they would gladly accept lower salaries if it would ensure "universal, quality care for our nation."

The six authors take issue with health care's current fee-for-service model, paying physicians for each test, procedure and visit they provide.

That system "rewards specialty care while marginalizing sensible primary care, mental health and preventive medicine" the authors write. Doctors don't get reimbursed for coordinating care for chronic conditions, even though managing such disease is vital for a patient's care, they say. Salaries, which remove such incentives are the way to go, they insist.

We realize the idealism of our goals. We do not expect to donate our services or to work for fees that fail to compensate us for the extensive training we now pursue. We also realize we are asking for nothing less than an overhaul of the health care system. Nonetheless, all of us, whether bound for specialty practice, academic medicine or primary care, are committed to health care reform that places patients first.

Just a bunch of starry-eyed kids, you say? Well, they aren't the first to object to the fee-for-service model.

Continue reading "Hopkins med students: We'll trade lower pay for health reform" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

Maryland's former Lt. Gov. Kathleen Kennedy Townsend takes aim at American Catholic Bishops' support of restricting abortion funding in health care reform legislation.

In this fiery Op-Ed in the Politico, published just before the Senate defeated an amendment this week that would place new abortion restrictions in the health care bill, she lashes out at bishops she says have "lost their way."

Why is it that the bishops are more concerned with restricting millions of American women from making health care decisions that are best for them and their families than they are with ensuring that millions of Americans — women, men, children, immigrants, the poor, the middle class — get much-needed health insurance?

As a Catholic and neice to the late Sen. Ted Kennedy, a health care reform champion, she seems to take the U.S. Conference of Catholic Bishops actions personally. The influential bishops have emerged as a force in the health care debate, heavilly lobbying lamwakers and sending alerts to followers urging them to support the Senate amendment.

Townsend urges the bishops not to let the single issue of abortion prevent what she sees as a moral imperative of expanding health care to those who need it most.

Continue reading "Kathleen Kennedy Townsend enters the health reform fray on abortion" »

Posted by Kelly Brewington at 7:22 AM | Permalink | Comments (14)
Categories: Health care reform
        

A group that's been lobbying for health care reform is hoping to get the public in on the action tonight. The Maryland chapter of Health Care for America plans six vigils around the state around 5:30 p.m. 

The sites:

• Annapolis at 5:30 p.m.: Sen. Mikulski's District Office, 60 West St.

• Baltimore City at 5:15 p.m.: Washington Monument, 700 N. Charles St.

• Columbia at 5:30 p.m.: Corner of Little Patuxent Pkwy & Sterrett Pl. across from Columbia Mall

• Hagerstown at 5:30 p.m.: Public Square, at the intersection of Potomac & Washington streets

• Hyattsville at 5:30 p.m.: 6700 Belcrest Road

• Silver Spring at 5:30 p.m.: Woodside Park, Spring Street and Georgia Avenue

The group says it wants Congress to pass reform and make health care affordable. It also wants Congress to reform the insurance industry, avoid taxing the middle class and pass a public option -- which the groups says is supported by 70 percent of Americans. 

The group also argues that the leading cause of bankruptcy is medical debt. 

“We urge Senate Majority Leader Harry Reid, as well as Senators Cardin and Mikulski, to continue to stand with Maryland’s families by doing everything in their power to pass health care reform that provides the choice of a strong national public health insurance option. With 2,547 Americans going bankrupt from medical costs every day, we can’t allow a few senators to derail what the majority of Americans want and need,” said Matthew Weinstein, Maryland coordinator of Health Care for America Now, which is cosponsoring the vigils with MoveOn.org.

The House has passed its version of health care reform, and the Senate is currently debating its measure. If it's passed, the chambers will have to reconcile the bills.

So, if you'd like to join the lobby effort for health care reform -- or even take another position -- here's your chance.

Photo courtesy of MoveOn.org

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

For millions of laid off workers, COBRA, the federal program that allows workers to keep their health benefits, has been a lifeline.

But this week, the government ended crucial subsidies that allow many workers to afford the steep price of keeping their insurance.

That result: hundreds of thousands of workers who relied on those subsidies will be forced to pay premiums as high as three times what they are paying now.

People who began receiving the subsidies in March, when they started, lost the benefit on Monday. The subsidies last nine months.

Consumer advocacy group Families USA warns that will cause many to join the already crowded ranks of the uninsured. In Maryland, average premiums could rise from $397 a month with the subsidy, to $1,133 without the government help, according to the new study from Families USA, which outlines costs for each state and urges congress to extend the subsidies.

Some Democrats in Congress are pushing to extend the subsidies for laid off workers, according to this McClatchy story.

There's no question the subsidies have been vital to people who have been laid off. From February -- the month before the government started the subsidy -- through August, COBRA enrollment doubled, according to an analysis by Hewitt and Associates, a human relations consulting firm.

Posted by Kelly Brewington at 7:18 AM | Permalink | Comments (2)
Categories: Health care reform
        

As the Senate begins debate on its version of a health care overhaul bill, big questions remain on hot-button topics like abortion and the public option.

But another issue that will intensify debate is whether the proposal controls skyrocketing health care costs.

In a story yesterday, we examine how lawmakers are taking aim at high-cost hospitals with provisions that worry large -- and expensive-- academic medical centers such as Johns Hopkins and the University of Maryland.

Lawmakers are drawing on influential research from Dartmouth that shows huge disparities in Medicare costs in hospitals nationwide as evidence of waste in the system. Maryland ranks sixth highest in Dartmouth research of Medicare spending in the last years of a chronically ill patients' life. Hopkins and Maryland are the state's priciest hospitals.

The health care bills would examine differences in costs and could limit how much expensive hospitals get from Medicare. In addition, the bills would clamp down on overall Medicare payment rates.

Continue reading "Senate debates health care bill -- will it control costs?" »

Posted by Kelly Brewington at 12:30 PM | Permalink | Comments (4)
Categories: Health care reform
        

The volatile issue of abortion has come front and center to the health care reform battle with wrangling over health insurance coverage of the procedure.

But a new poll suggest that while most Americans don't support public funding for abortions, the issue plays only a small role among those who oppose reform, according to the poll, by the Pew Research Center.

When asked directly about whether abortion should be a benefit of a government health care reform plan, the majority -- 55 percent -- said no way. But when asked to explain in their own words their opposition to health care reform, just 3 percent of opponents said their objection to reform was because of abortion, the poll found. 

While it may not be the sole reason for discontent with the health overhaul, it was among a few. About 56 percent of opponents listed abortion as one of the major factors in their opposition, the poll found. Still, concern about costs and the expanded role of the government ranked far higher.

The poll, conducted between Nov. 12 and 15 asked a little over 1,000 people their thoughts on abortion and health care reform.

Two weeks ago, the House voted to probhibit federal subsidies for insurance that covers abortion in its version of the health care bill. The Senate's version does not have that stipulation at the moment. Expect the issue to be fought hard in the Senate. An interesting side note, this Politico story explains how taxpayers already provide subsidies for health care plans that cover abortions.

Back to the poll. While many Americans had strong feelings on the legislation proposed in Congress, lots of folks said the bills were too complicated and a good 19 percent said they didn't know what to think of them. Go figure.

Continue reading "Poll: abortion plays a small role in health reform opposition" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

The Sun has launched a new feature we hope will keep us better connected with readers and help us tell stories about the economy that are most important to them. 

By joining Light Source, you'll get a monthly email asking about your experience with various economic topics. This month: health care. We'll use the answers to help shape stories that you will eventually read in The Sun's news pages and on its website. You'll be our new network of real-life experts.

We know Picture of Health readers have lots to say about health care reform. Whether you're a provider, patient or insurer, we want to hear your issues and concerns. Check it out here and let us know what you think.

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (1)
Categories: Health care reform
        

After months of partisan debate and political wrangling, the Senate Finance Committee prepares its crucial vote today on legislation to overhaul the nation's health care system and expand insurance to many of the nation's 47 million people without coverage. 

We figure this is as good a time as any to take the pulse of our Picture of Health readers on what they think of the plan.

The bill would raise the number of Americans with insurance from 83 percent to 94 percent and cost some $829 billion over a decade and Sen. Max Baucus, the committee chairman, says he's got the votes to get it approved. It would also expand Medicaid, require most Americans to have health insurance and impose a fee on most employers who don't offer insurance to their employees.

If you're interested in further details on the bill, the Kaiser Family Foundation has a great web tool that allows you to get the highlights and compare it to other plans being batted around in Congress. Check it out here.

A recent poll by Consumer Reports found that just 64 percent of Americans are satisfied with their current health care plans. Another new study by the nonpartisan think thank the Brookings Institution sheds light on how the public feels about a host of health care reform issues.

For instance, a the Brookings poll found that three in five Americans think the government has the responsibility to ensure that citizens can meet their basic need for health care and two out of three think the government is doing a bad job at meeting those needs.  Among the other key findings:

• A majority favors a public insurance option -- which would compete with the private sector -- should be available to all, while three-quarters think it should be limited to people who cannot get insurance through their employers.
• Three in four Americans said they were concerned that the cost of health insurance may soon be too great for their families to afford.
• The public is split on individual mandates -- requiring most Americans to have insurance for themselves and their children, with subsidies for low-income people to help them pay for coverage. Those who don't get insurance risk a financial penalty. 52 percent agree with the mandate, while 44 percent did not.

So, what do you think? Like a public option? Hate individual mandates? Think there's not enough pressure on insurance companies to do right by patients? Sound off!

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (8)
Categories: Health care reform
        

Everyone is making their voice heard on health care reform it seems, but there's one group that has been noticeably absent from the fray and experts say they have the most to gain from reform: minorities.

Well, this week some of the nation's most influential minority advocacy groups have stepped up to demand a voice at the table as Congress continues to battle over how to overhaul the nation's health care system. The NAACP, the National Council of La Raza and the Leadership Council on Civil Rights and others have joined forces to advocate for reform.

Blacks and Latinos are more likely than whites to go without health care because they can't afford it, are less than half as likely as whites to have a regular doctor and minorities have among the highest rates of being uninsured.

Preaching that health care is a moral imperative, the groups are taking to the airwaves with an ad campaign, for which the details can be found here: http://www.healthequityforall.org. They're pushing for a comprehensive coverage and quality for all and a plan that includes what has been at the core of the health care fight lately: a public insurance option.

Continue reading "Minorities groups speak out on health care reform" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

Maryland ranks 17th in the nation for health care quality, access and affordability, according to a new study by the Commonwealth Fund, which reveals stark differences in care among the states.

The state didn't make it to the top tier of 13 states such as Vermont, Hawaii and Maine who continued to improve quality measures and decrease the ranks of the uninsured. But Maryland held steady for the second year (it was ranked 16 the year before) in the second tier of states doing a decent job amid a "health care system under stress, with deteriorating health insurance coverage for adults and rising health care costs." the report states.

Maryland, for instance, is among just three states with premiums averaging under 14 percent of median income -- far more affordable than the lower ranking states, the report found. Some 83 percent of adults have insurance, just a bit lower than the 86 percent of adults who are insured in top-ranking Vermont.

Continue reading "Health care score card: Maryland ranks 17th in nation" »

Posted by Kelly Brewington at 12:19 PM | Permalink | Comments (0)
Categories: Health care reform
        

Recent data from the U.S. Census showed some stark geographic disparities in who has health insurance coverage and who doesn't.

An analysis by the Associated Press found that people who live in the Southwest are many times more likely to lack health coverage than residents in the Northeast and Midwest. The reason? Varying state laws, job industries and demographics.

The folks at NPR put together a very cool map about how congressional districts stack up. Take a look. (As a reporter who once covered demographics, I admit, I get really geeked about interactive maps!)

In addition, a piece explained how regions with the highest percentage of uninsured people also happen to be the places with the staunchest opposition to health care reform. Huh? you might ask...

Continue reading "Got health insurance? Depends where you live" »

Posted by Kelly Brewington at 7:23 AM | Permalink | Comments (0)
Categories: Health care reform
        

Our friends over at the Consuming Interest blog will hold a live chat at noon Monday on health care reform. Got questions you'd like to ask a health care expert? Columnist Eileen Ambrose will bring you two policy experts from Johns Hopkins Bloomberg School of Public Health.

Feel free to ask questions in advance by emailing Eileen: eileen.ambrose@baltsun.com.

Posted by Kelly Brewington at 4:09 PM | Permalink | Comments (0)
Categories: Health care reform
        

And you thought Death Panels was so last month. The debate over end of life costs is back at the fore this month in an interesting article in Newsweek, called "The Case for Killing Granny." 

"My mother wanted to die, but the doctors wouldn't let her," the story begins.

Beyond the provocative headline (it doesn't really advocate for offing anyone's grandma) it gets at the heart of what it calls a crucial issue facing lawmakers as they try to overhaul the health care system. "The need to spend less money on the elderly at the end of life is the elephant in the room in the health-reform debate."

It's time, the author says, to finally have a discussion about dying, something American's are terrified of.

The article makes the case that the root of uncontrolled soaring health care costs is the money spent to keep very sick, very old people alive. Doctors are encouraged to order more tests and keep treating people because of how they are paid -- by each procedure, test and doctors visit. And this fee-for-service model does not result in better quality care, the article concludes. This argument is nothing new -- articles on health care are talking about it every day. 

But what I found most interesting was the discussion near the article's end about the philosophical aspect of health care. People go to the doctor "to try to make themselves feel better, even if the doctor is not doing much physically to heal what ails them" the article states.

The story discusses a program in Massachusetts is trying to change that reliance on health care, by assigning nurses to the sickest and costliest patients, giving them basic care before deciding if a doctors visit is really necessary. The program cut costs by 5 percent.

Continue reading ""The Case for Killing Granny"" »

Posted by Kelly Brewington at 7:12 AM | Permalink | Comments (5)
Categories: Health care reform
        

Racial health disparities cost the United States $229 billion between 2003 and 2006, money that could help pay for an overhaul of the nation's health care system, according to a new report by Johns Hopkins researchers.

"The statistics are just stunning and shocking," said HHS Secretary Kathleen Sebelius, during an announcement of the findings this morning. "There is no question that reducing the health disparities can save incredible amounts of money. But more importantly it saves lives and it makes us a healthier and more prosperous nation."

Up until now, those fighting to close racial health gaps have made their pleas on moral grounds. Confronting why black men are twice as likely to have prostate cancer than white men, is simply the right thing to do, they say. But the new figures aim to break the issue down into dollars and cents at a time when everyone is concerned about soaring health care costs.

"What we are arguing in this report is if you want to get a handle on health care costs and quality and ensuring that the U.S. has a healthcare system that is worthy of this nation, you need to account for disparities," said Thomas A. LaVeist, director of the Hopkins Center for Health Disparities Solutions and the report's author. "And the economic effect of the disparities alone could likely pay for the care for those who don’t have access now."

Continue reading "Fixing racial disparities could mean billions to pay for health care reform" »

Posted by Kelly Brewington at 12:26 PM | Permalink | Comments (1)
Categories: Health care reform
        

Admit it: the health care debate is confusing. Your eyes gloss over at terms like "bending the cost curve" and "health insurance exchange." You're not sure how a public option might be different from a non-profit co-op and why you should even care.

You want to know what this plan might mean for you and you want it in simple language that makes sense.

You have plenty of company. Nearly all Americans -- 93 percent -- think the reform debate is important and yet more than two thirds -- 67 percent -- say the issue is difficult to understand, according to a new poll by the Pew Research Center for People and the Press. 

Here at Picture of Health, we don't blame you for your confusion. We, too, are sifting through the massive bills, the endless spin to help boil down the issue to important and interesting nuggets for our readers. And it's not always easy.

With that in mind, we want to help. We want to hear from you. What do you want to know about health care reform? What do you worry about most when it comes to health insurance? And if you could ask any question to a member of Congress or a health care expert what might that be?

Share here in this space, and we'll work on getting you the answers.  

AP photo

Continue reading "Confused about health care reform? Join the club" »

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (10)
Categories: Health care reform
        

Dr. Ari Silver-Isenstadt is a pediatrician. Most of his young patients have health insurance, either private or through Maryland's Children's Health Insurance Program. But, as he writes in a letter to the editor published in the Baltimore Sun today, their parents -- many times -- go uncovered. The activist Laurel doc is a major proponent for the public option as a way to ensure universal health care. Regardless of where you stand on this, listen to what he sees in his practice:

My patients' parents are less well covered. It is not unusual for a parent to ask me about his or her own health issues during a visit for the child. These parents do not have their own physicians and often they look ill; they do not have health insurance to help cover the cost of medical care. ...

Continue reading "One pediatrician's take on health care reform" »

Posted by Stephanie Desmon at 11:27 AM | Permalink | Comments (0)
Categories: Health care reform
        

The U.S. Census just released some surprising figures on the number of Americans without health insurance. The agency says the percentage of the uninsured did not grow between 2007 and 2008 -- holding steady at 15.4 percent. Meanwhile, the number of uninsured people rose slightly 45.7 million to 46.3 million.   

During a monster recession, with rising unemployment and so many employers cutting health insurance to their workers -- can those figures be right? 

Just how many Americans lack insurance has been a tough figure to pin down. In his pitch to reform the health care system and expand coverage to every American, President Obama often says there are 47 million people among the ranks of the uninsured. But other estimates from government agencies and interest groups vary widely from tens of millions of people -- in one way or another.

A closer look at the Census figures, however, sheds some light on what might be going on. For one, the number of adults without health insurance increased from 19.6 percent to 20.3 percent between 2007 and 2008, while the number of uninsured children decreased substantially, perhaps offsetting the adult numbers.

Drill down a bit more and it's clear that more Americans appear to be losing their employer-sponsored insurance while at the same time more people are getting coverage from the government -- from Medicaid, Medicare and the Children's Health Insurance Program.

Continue reading "New figures on uninsured -- but just how accurate are they?" »

Posted by Kelly Brewington at 11:35 AM | Permalink | Comments (4)
Categories: Health care reform
        

Sarah Palin is talking death panels again. This time, instead of using Facebook, she is recycling this bugaboo in the pages of The Wall Street Journal this morning.

Hoping to grab attention on the morning of the president's health care address to Congress, she criticizes Obama's desire to create an Independent Medicare Advisory Council, what she calls "an unelected, largely unaccountable group of experts charged with containing medical costs." Using Obama's words, the failed 2008 vice presidential candidate says this group "should guide decisions regarding that 'huge driver of cost ... the chronically ill and those toward the end of their lives ...'"

Given such statements, Palin writes: "[I]s it any wonder that many of the sick and elderly are concerned that the Democrats' proposals will ultimately lead to rationing of their health care by -- dare I say it -- death panels. Establishment voices dismissed that phrase, but it rang true for many Americans."

Continue reading "Deja vu: Palin and death panels" »

Posted by Stephanie Desmon at 10:39 AM | Permalink | Comments (9)
Categories: Health care reform
        

Lawmakers are back in Washington today to wrangle over health care reform -- particularly the cost of overhauling the system.

But what about the cost to individuals? Lawmakers want to expand insurance to some 47 million Americans. But what if the premiums are still too high for folks to afford them?

I take a look at the affordability question in a story today that draws on an example from Howard County. There, an innovative program offering access to doctors for as little as $50 a month -- far cheaper than any of the Congressional proposals would offer. Yet, it's still too expensive for some people.

Key to making insurance affordable would be providing subsidies large enough for low and moderate income people.  But for now, Congress hasn't decided how many people would qualify for subsidies and for how much.

Dr. Peter Beilenson, Howard County's health officer, told me that the subsidies should be vastly increased to make insurance affordable to more Americans. But just where would that money come from? For now, I guess we'll just have to stay tuned to the debate ...

photo courtesy of stock.xchng

Posted by Kelly Brewington at 7:02 AM | Permalink | Comments (5)
Categories: Health care reform
        

Checked your Facebook account lately? Are you seeing what we are? Status updates that go something like this:

No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day

Or this:

No one should die, go blind, or be crippled because they can't afford health care. No one should go broke because they get sick. No one should be unable to change jobs because of a "pre-existing condition." If you agree, please post this as your status for the rest of the day.

The beginning of a health care reform movement? Or just idle chit chat on a social networking site where folks are constantly trying to impress their "friends?" And will an anti-reform response be next?

AP photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Health care reform
        

Whether spending now to prevent chronic illnesses actually reins in costs is a huge issue  lawmakers will confront when they return to Washington next week to battle out health care reform.

Many lawmakers and the Obama administration assert there will be huge savings down the road from preventing chronic diseases now -- enough to pay for a health care overhaul. But a new study from the journal Health Affairs, pokes holes in those claims. Researchers found that while costs will likely decrease over time, prevention efforts will not result in enough savings to pay for reforming the entire health care system. 

Still, the authors say, if the government took a longer view on costs, it would see greater savings. The Congressional Budget Office projects the cost of prevention efforts over 10 years, and finds that most preventive services, result in greater spending, not savings. But the study's authors think the government would find a rosier picture if it projected out 25 years. The bottom line:

 "There's no free lunch here. Prevention will not pay for everything. But it's not as expensive as it looks at first blush," said Michael J. O'Grady, a senior fellow at the National Opinion Research Center at the University of Chicago, told the Washington Post.

Continue reading "Does preventing chronic illness now pay off later? " »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Health care reform
        

Caught this testy exchange this morning on NPR as I drove into the parking lot: Morning Edition host Steve Inskeep taking on RNC Chairman Michael S. Steele, Maryland's former lt. governor.

The topic: Health care reform, what else? Inskeep took Steele to task for an op-ed piece he wrote for Monday's Washington Post. In it, Steele wrote a clever line I'm sure he has used more than once: "President Obama's plan for a government-run health-care system is the wrong prescription." Later, he lays out his call for a "Seniors' Health Care Bill of Rights." The First Amendment: Don't cut Medicare, a program he acknowledges is going to run out of money.

"Within a couple of paragraphs of writing we need to protect Medicare, you write that you oppose President Obama's plan for a 'government-run health-care system,'" Inskeep said. "Now you're a veteran public policy official. You're aware that Medicare is a government-run health care program?"

Continue reading "NPR vs. Michael Steele on government-run health care" »

Posted by Stephanie Desmon at 11:15 AM | Permalink | Comments (21)
Categories: Health care reform
        

As friends, colleagues and even political adversaries offer praise and remembrances for Sen. Edward Kennedy, who died last night after a battle with brain cancer, everyone underscores his huge influence on efforts to overhaul the nation's health care system.

He called health reform the "cause of my life" during last year's Democratic National Convention, said it was a "defining issue for our society" years earlier, and throughout his recent illness continued to champion universal coverage while pushing Congress to act now on legislation.

"He pursued that cause vigorously, even as his health declined; when members of Obama’s administration questioned the president’s decision to spend so much political capital on the seemingly intractable issue, Obama reportedly replied, “I promised Teddy.’’ noted The Boston Globe adding that Kennedy's long committment to health care issues began in 1969.

Yet, he died with "one of his lifelong goals, universal health care, tantalizingly within reach yet struggling on Capitol Hill."

Beyond reform, Kennedy was instrumental in other legislative issues concerning health including helping create state health coverage for poor children known as S-CHIP, building federal support for community health centers and pushing successfully for increases in cancer reasearch funding.

The Wall Street Journal notes that his death has already become a rallying cry for passing reform legislation this year while others ponder, who will fill the shoes of the man called the lion of the Senate?

photo: AFP/Getty imags

Posted by Kelly Brewington at 1:20 PM | Permalink | Comments (2)
Categories: Health care reform
        

And you thought the uproar over "death panels" had reached a fever pitch. Well, here's another topic making the heated rounds in the health care reform brawls: Should illegal immigrants be eligible for coverage?

First off, none of the plans currently in Congress include illegal immigrants. President Obama and Nancy Pelosi have made a point of underscoring this lately. In fact, up until the town halls got ugly in recent weeks, no one in Congress was even talking about health insurance for illegal immigrants. That hasn't stopped angry opponents from asserting all sorts of false claims -- free insurance to non-citizens, among them. (PolitiFact debunks a that claim, for the record.)

It also hasn't stopped immigrant advocates from asking -- wait a second, what about us?

There's a moral obligation to provide access to health coverage to all Americans, regardless of their immigration status, they say. Any plan that excludes illegal immigrants will fall short, says the advocacy group the National Council of La Raza, considering that illegal immigrants account for 15 percent -- nearly 7 million -- of the nation's 47 million uninsured. But proponents of strict immigration enforcement counter that providing insurance would only encourage more immigrants to flock here illegally.

Continue reading "Illegal immigrants and health care reform" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (39)
Categories: Health care reform
        

Laid-off workers have been flocking in recent months to COBRA, the federal program that has long allowed them to keep their employers' health insurance for 18 months -- but for a hefty price.

Lots of people have become eligible for the program -- with unemployment at a 25-year high -- but few are able to afford it when they lose their income. COBRA allows involuntarily terminated to pay 100 percent of the premium plus 2 percent for administrative costs. The cost: roughly $8,800 a year for the average worker.

The doubling of COBRA enrollment has been since February, when the government began paying a subsidy to make the coverage actually affordable to some unemployed people, according to an analysis by Hewitt Associates, a human resources consulting firm.

Continue reading "COBRA enrollment doubles with subsidy, study says" »

Posted by Stephanie Desmon at 10:47 AM | Permalink | Comments (0)
Categories: General Health, Health care reform
        

Apparently cowed by protestors and talking heads who called plans to pay doctors to assist with end-of-life decisions "death panels," a Senate committee has dropped the provision from its health care reform bill.

The idea was to let Medicare pay for these voluntary counseling sessions, where items such as living wills and hospice care would be discussed. What rankled many seemed to be that these sessions were billed as cost-saving measures. The last year of life is the most expensive and one recent study concluded that much of end-of-life spending isn't sought by patients and goes against their families' wishes, according to yesterday's Wall Street Journal.

But many saw a more sinister motive. They equated these end-of-life sessions with rationing care for the elderly and even euthanasia, calling them death panels which would play God and decide who would live and who would die. And the concerns didn't only come from sign-waving protestors and an angry Sarah Palin, the failed 2008 vice presidential candidate. Sen. Charles Grassley, the top Republican on the Senate Finance Committee, said yesterday that the provision was dropped because it wasn't just about providing information at the end of life, but was "likely to lead to the rationing of care for everyone."

Continue reading "Senate drops end-of-life "death panel" provision" »

Posted by Stephanie Desmon at 7:17 AM | Permalink | Comments (10)
Categories: Health care reform
        

The White House launched full court press against what it says is misinformation being spread about health care reform by protesters at raucous town halls nationwide.

On Monday, the administration released a new website aimed at countering the attacks and at a town hall Tuesday, President Obama said flat out: his health care plan won't "pull the plug on grandma."

He was referring to euthanasia claims made by fierce opponents to reform proposals, including none other than Sarah Palin, who said on her Facebook page that the "downright evil" plan will lead to health care rationing:

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care."

Now, let's get this straight. Palin was referring to a provision that would allow Medicare to reimburse doctors for consulting seniors about living wills, advanced directives and end-of-life care. Sound like a death panel to you? The Associated Press says there's nothing in the bill about "death panels". Pulitzer-prize winning PolitiFact.com also debunks the claim. And if you're interested, here's the actual bill with the information -- see pg. 425,.

Continue reading ""Death Panels" and the war of words over health care reform" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

My Sunday story focused on a key question in health care reform -- will there be enough doctors to go around? With plans to extend insurance to some 47 million people, the current primary care doctor shortage will only get worse, many say. One solution could be to increase the role of nurse practitioners. 

The piece generated positive feedback and lots of interesting responses from readers across the spectrum about primary care, nursing and the reform debate. I also heard from a group of providers who felt overlooked: physician assistants.

I hope folks don't see this as an intentional slight, as the story was a narrowly-focused piece looking at one slice of the health care debate. But it is true that using more physician assistants is among the solutions being tossed around to help fill the primary care gaps. And some observers think they could play an important role.

Continue reading "Physician assistants and health care reform" »

Posted by Kelly Brewington at 11:11 AM | Permalink | Comments (9)
Categories: Health care reform, Physician shortage